Initially, this may go unnoticed by most people. The symptoms of gingivitis typically worsen. The gums may be slightly more tender and can have a greater tendency to bleed. Periodontal pockets will measure in the range of 3 to 5 millimeters. (One millimeter is about the same thickness as a dime.)

What can be done: Once periodontitis has set in, good oral hygiene should remain top priority, but specific periodontal treatments will be needed. For mild periodontitis, a conservative, nonsurgical approach can still be used to get the disease under control.

The first step is scaling and root planing, a deep cleaning technique. Scaling and root planing remove plaque and calculus (tartar) from under the gum line and smooth any bumps or rough areas on the tooth roots, where plaque tends to accumulate.

In some cases, antibiotics are used in combination with scaling and root planing. Antibiotics to treat periodontal disease can be swallowed as a pill or applied in gel, powder or chip form and placed directly into the affected area of the mouth.

When scaling and root planing and/or antibiotic treatment are not successful, periodontal surgery may be needed.

Important: Unlike in gingivitis, the effects of periodontitis are not always reversible. Even if the disease is brought under control, it is a chronic condition that can always resurface if oral hygiene becomes lax. It's important that people diagnosed with periodontis diligently follow up on their periodontists' recommendations.